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The Gift of Life

Organ donation, the mitzvah not enough of us keep

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The other day, Josie was reading my dad’s website. Dad died in 2004, when Josie was almost three. His site, which he started in the late ’90s, is a living testament to his entertaining lunacy. A stream-of-consciousness blog from an era before blogs, it contains Dad’s epic restaurant reviews, copies of his ranting letters to various corporations (always concluding with a demand for a promotional t-shirt), and photos of stopped-up Amtrak toilets.

Josie most loves reading Dad’s entries about her. Dad was utterly enchanted by my daughter, whom he believed to be a musical and linguistic prodigy. It’s one thing for me to tell Josie how much her zayde loved her; it’s another thing entirely for her actually to read my dad’s breathless descriptions of her adorability and brilliance. (When she was two-and-a-half, he wrote about her skill with a jigsaw puzzle. Josie recently read it aloud, her finger on the screen: “She is much better at it than either Carol or I. She is patient and persistent. She is a fucking genius.” Then Josie clamped her hand over her own mouth, eyes huge, and gasped, “Zayde used the F-word!” Yes, honey, he did. Often.)

Does Josie really remember him? She assures me she recalls sharing an Eskimo Pie with him in the car and flying kites with him in Newport. I’m not sure she really does. But in the here and now, she reads his narratives, coos over the pictures of him holding her, gets to know him through his own colorful writing. I’m so grateful to my geek husband for hosting the site and keeping it alive.

When Jo and I read Dad’s words together—she sits on my lap at my desk, clicking and giggling—she’s completely in the moment. But I’m not. I can’t help noting the date of every post. Five months before his death. Three months. I note every passing reference to dialysis and the ICU, the increasing number of times he mentions feeling sick and weak. In every pixel I feel his hunger for more time with Josie, more life, more Russ & Daughters lox. He called himself Farklempt (as in “I’m a little farklempt!”), and that was him all over—emotional, hilarious, and outrageous. The very last post on the site has no words. It’s a picture of Maxine, in utero; he’d scanned the ultrasound printout. He couldn’t wait to hold her, to embarrass me by describing her poops on the internet. He died two months after posting it, without ever meeting her.

Dad died while waiting for a heart and kidney transplant, one of 8,000 Americans who die waiting every year. According to United States government statistics, there were more than 103,000 people on the national organ transplant wait list in September 2009. Every 11 minutes, another name is added to the list. While 90 percent of Americans say they support donation, only 30 percent have organ donor cards.

And, unfortunately, Jews have the lowest rate of donation of any religious group. In Israel, only four percent of citizens sign up to be organ donors. In that tiny country, there are 1,000 people on the wait list and 100 die every year. Many Jews, in both Israel and America, believe that our religion prohibits organ donation. But according to almost all Jewish authorities, that’s untrue. Jewish law does prohibit cutting a dead body, part of the principle of kavod ha’met, showing respect for the dead. But that commandment, like all commandments, is overridden by the mitzvah of saving a life: pikuach nefesh.

In the 1960s, Judaism’s Reform and Conservative movements declared that brain death, the cessation of all electrical activity, meets the halachic definition of death. (No one has ever recovered from brain death, which is not to be confused with coma. And for organs to be transplanted, they need to be taken from a body that’s kept breathing artificially.) In 1989, Israel’s chief rabbinate agreed with this definition, and in 1991, the Rabbinical Council of America (which speaks for the Modern Orthodox movement), followed. Agudath Israel of America, an ultra-Orthodox group, differs from the other organizations, stating that each person should talk to his or her own rabbi about whether donation is permissible. Most rabbis, however, say that it’s not just permissible but a mitzvah.

The Halachic Organ Donor Society exists to encourage more Jews, religious and not, to donate. (Its acronym, HOD, is the Hebrew word for glory.) It was founded with financial support from the parents of Alisa Flatow, a 20-year-old Orthodox girl who was killed in a 1995 suicide bombing in Israel. Her organs transformed the lives of six Israelis. Now, in addition to providing education on organ donation, the HOD Society offers two versions of a Jewish Organ Donor card. One uses brain death as the standard (which would allow transplantation of all organs). The other uses the cessation of heartbeat as the standard (which would allow transplantation of corneas, and would satisfy almost all ultra-Orthodox rabbis).

In 1997, the U.S. Department of Health and Human Services launched its own initiative, called National Organ Donor Sabbath. It always takes place two weeks before Thanksgiving; that’s November 14-15 this year. Rabbis, priests, imams, and ministers are all encouraged to discuss organ and blood donation with their congregations. Tell your rabbi!

My dad always loved the fact that I give blood regularly. But to me, it’s a no-brainer. It doesn’t hurt much, it helps other people, you get to skip out of work without anyone raising an eyebrow, and you get free cookies. My dad couldn’t donate because of his health; my brother can’t donate because he’s gay; my husband can’t donate because he used to live in England. That’s why the rest of us have to step up. According to the Red Cross, 60 percent of Americans are eligible to give but only five percent do. (To find out where to donate near you, go to the Red Cross’s Give Life site or the American Association of Blood Bank’s donation center locator.)

I always take the kids. They like free cookies even more than I do. And it’s a good way to model my values, plus it de-scarifies needles. (Or so I tell myself. It hasn’t made their vaccination appointments any less scream-filled.) As I bleed into a baggie, I always think about Dad and wish he could see the girls now. Josie is an entirely different human. Maxine—his kind, funny, and very, very weird namesake—would have delighted him.

Years ago, when Dad was in the ICU for the first time (getting resuscitated after his first heart attack at 39), he yelled for a pen. And he wrote an ethical will, his rules for living, should my brother and I grow up without him. “Rule #1,” he wrote: “Never, never take anything too seriously. Especially yourself. Rule #2: Belch loudly at the dinner table. It is a compliment to the chef, and a long-established Ingall tradition. Teach your children this, above all.” I’ve tried to live by Rule #1, but I’ve failed miserably on Rule #2. I cannot burp on cue. Josie can’t either. Maxine, however, has the gift of burping the entire alphabet so loudly our across-the-hall neighbor can hear her.

My father would have been so proud.

And if more people were organ donors, maybe he’d be applauding her magnificent talents right now.

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notty rybak says:

Rav Avraham Steinberg’s presentation was absolutely brilliant. Perhaps one may be permitted to refer to it as a ‘maculate’ presentation.

Louis Zivic says:

Rabbi Steinberg’s presentation helps make the problem of Jewish organ donation real. When do you suppose the Jewish people will awaken and join the 21st century?

Judith Nusbaum says:

As a kidney recipient and a volunteer with HODS and ADI organ donor organizations, I applaud Ms. Ingall’s article. However, I must correct her facts regarding Israel. Today, approximately 10% of Israel’s hold ADI cards. Progress is being made thanks to Tamar Ashkenazi and the ADI staff.

Judith Nusbaum

Janice says:

In 2002 I received a liver from an anonymous organ donor. I was able to live to see my Daughter’s bat mitzvah and this year I had an adult Bat Mitzvah. Sadly, many peoplerelate better to donating by writing a check then stepping up to the plate. My donor was not Jewish-

Very interesting details you have remarked, thanks for putting up.


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The Gift of Life

Organ donation, the mitzvah not enough of us keep

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